UK’s Drug Strategy, Comments and Thoughts

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E O’Mara / GLADA Women’s Voices on the 2010 Drug Strategy:

As part of a group of women whom have been affected personally by drugs and alcohol, we, like so many others directly affected awaited the Coalitions Drug Strategy with trepidation. Most of us spent the year on tenterhooks as bullish Tory machinations kept throwing us tidbits of information on things like benefit reforms and coerced treatment, vague threats about time limited drug treatment, the feeling we could be ‘thrown to the dogs’ at any moment with GP commissioning and those undercurrents of recovery agendas that felt evangelical in their fervor.

All this had left us fearing just what the new drug strategy would hold and how it would affect the woman (or man) using drugs in Britain today. There was clearly some good stuff in there – a bringing together of much of the work that has emerged over the last decade or so in a reasonably progressive way – for a Tory drug strategy (oops Coalition!). But there was very little substance, very little ‘strategy’ at all in fact other than its 3, reasonably vague themes of Reducing Demand, Restricting Supply and Building Recovery.

How it plays out over the next few years will be down to the workers on the ground. Which is, we surmise, what ‘The Big Society’ had in mind all along. For me, as someone who is in treatment, I have fears around the oncoming onslaught of Charitable institutions rushing to be ‘recovery kings and queens’, shaping themselves to fit what the new ‘Public Health England’ wants rather than the service user really needs. This will be especially pertinent in the areas that pilot the new ‘payment by results’.

To comment further, there are several areas that emerge as concerns for women who use drugs/alcohol.

On Women: The drug strategy fails to mention women as a group with particular requirements – at all. The long awaited (but never mentioned) hope of drug treatment clinics or services that are able to offer women more integrated support around abuse and domestic/violence, or access to crèche facilities while they attend treatment, or even rehabilitation clinics that can take women with their children, of which there is a currently a chronic shortage, were all missing.

All we get from the strategy on the latter is a rather mealy mouthed two lines stating they will be “Developing and evaluating options for providing alternative forms of treatment-based accommodation in the community”.

Families: As is the case so often with these things, we get much talk from above about supporting families to do well, but little in the way of really practical guidance or direction about what women actually need on the ground, day in, day out.

It is good to see that the ‘Impact of parental substance misuse will be considered as part of the consultation to develop the social work degree curriculum and will be taken into account through the Munro Review of social work practice’. I am taking this to mean we will have progress around educating social workers around drugs and drug use, although I expect the devil will be in the detail as to who trains them and how.

Mental Health: We are also given a small paragraph on mental health, and nothing about addressing the massive gap between drug services and mental health units as clients/patients are shunted back and forth as part of the current system. It is a tragedy to see an omission here, the once more ‘too hard basket’ gets pushed to the back at the expense of thousands of vulnerable women (and men) who struggle with mental health and substance misuse problems and find themselves with no where to go where they feel understood or supported or catered for regarding complex drug treatment regimes.

Harm Reduction? The strategy does not mention the term ‘harm reduction’ once. This is an obvious omission and one which no doubt was on purpose. It is concerning because in one foul swoop we have wiped away any strategy or response to the issues encountered by the majority of our drug using population who are not in treatment, or don’t consider themselves to be ‘problematic drug users’. There is nothing except ‘FRANK’ mentioned about providing good quality, non judgmental education on drugs and head shops remain as isolated as legal highs are in limbo land. Where are all the drug users over 21 supposed to go for ‘grown-up’ information and advice on drugs and alcohol? They won’t be going to FRANK I’m afraid and unless the RELEASE Drugs Helpline is able to pull the proverbial rabbit out of the hat, the UK will lose its only quality, non judgmental drugs helpline altogether. A really misguided state to be in to be sure and no help in sight in this drugs strategy.

Pulling Out Some Strategy Threads

On Temporary Bans and Legal Highs.

“The use of this provision will depend on the rate at which new potentially harmful “legal highs” are introduced to the UK market. A full Regulatory Impact Assessment will be completed on each occasion that the power is used, taking into account any evidence on prevalence of availability and use, in the same way when a drug is brought under permanent control under 1971 Act.”

On the ground: The temporary ban on suspect substances is talked up in this strategy, and it does have elements that are slightly hard to disagree with; None of us want to see UK citizens frying their brains with weird and obnoxious chemicals sold in shiny packets as legal substances. However, the government risks criminalizing many more thousands of otherwise law abiding citizens by potentially rushing through these decisions or cutting corners if they become to arduous/expensive and past an ACMD that ‘could be’ without robust scientific scrutiny (dissenting scientists will not get a look in if the Conservatives have their way). We could end up with substances keeping their ‘temporary’ ban and becoming over categorized, as what Conservative (oops Coalition) government would want to be seen to reverse or lighten a ban after the cannabis fiasco of New Labour? Better to be safe than sorry, I can hear them say (as the drug trade and prisons keep expanding ever onwards). In fact, why don’t I let the Drug Strategy say it “We will not classify drug problems at a local level as anti-social behaviour – drug dealing and drug possession is a crime.”

On the changing face of drug use:

On one hand the strategy talks about the diverse landscape of drug users today and does accept we have ‘groups of people who would not fit the stereotype of a dependent drug user (who) are presenting for treatment in increasing numbers.” It goes on.. “These individuals are often younger and are more likely to be working and in stable housing. We need to ensure that provision for these individuals is tailored and responsive. Services also need to be responsive to the needs of specific groups such as black and ethnic minorities and Lesbian, Gay, Bisexual and Transgender users.”

On the ground? Everywhere one looks one is seeing the homogenization of drug services, the ‘complete drug service’ that offers everything to everyone’. There is something to be said for this in order to avoid the repetition of services we were seeing several years ago in boroughs across London for example, but we have lost our small, unique, specialist services in the process. I really hope we do see provision for these specific groups however losing our culturally sensitive old school drop ins, is a quiet tragedy and I daresay in years to come we will be forced to come back to the ‘neighbourhood drop in’ again, though perhaps in a re-energised form. LBGT services that provide drug counseling and support are closing down as we speak.

There is nothing but a few lines addressing older users: “Data from treatment providers shows that the heroin using population is ageing, with fewer young people becoming dependent upon the drug. Those aged 40 and above now make up the largest proportion of those newly presenting for treatment.” And that’s that.

On young people who take drugs..

“The focus for all activity with young drug or alcohol misusers should be preventing the escalation of use and harm, including stopping young people from becoming drug or alcohol dependent adults. For those very few young people who develop dependency, the aim is to become drug or alcohol free. This requires structured treatment with the objective of achieving abstinence, supported by specialist young people’s services such as Child and Adolescent Mental Health Services (CAMHS). For the most vulnerable young people, a locally delivered multi-agency package of care – including treatment, supported housing, fostering and education support – is required.”

On the ground: Shortsighted statements like ‘stopping young people taking drugs’ do little to look at the issue realistically. Sometimes with young peoples services we put so much ‘adult’ stuff in the way, we put the bar up so high, that it becomes another service that offers little to the youth on the street with a drug problem. We need low threshold services, like caring and innovative young people’s drop ins and youth centres that offer an easy access point for young boys and girls, with the option of intensive support and mentoring from caring, friendly staff. It’s so important to develop accessible services for young women and girls, especially young mum’s to build self esteem and keep them plugged into the futures they want for themselves.

On Recovery:

“Individuals do not take drugs in isolation from what is happening in the rest of their lives. The causes and drivers of drug and alcohol dependence are complex and personal. The solutions need to be holistic and centred around each individual, with the expectation that full recovery is possible and desirable.”

On the ground: We can’t talk about this strategy without mentioning the word ‘recovery’. There has been some careful use of words here and it is good not to hear talk of illness or disease (thankfully we don’t need to play up to this to receive treatment as some of our peers in the USA do). However there is talk of ‘recovery champions’ being used but with a clear nod to Narcotics Anonymous and Alcoholics Anonymous who I fear, may feel their time has come. Lets hope they bring a more modern day approach and flexibility with them.

It was good to hear the importance of ‘building capital’ as an essential part to building recovery. • Social capital – • Physical capital – • Human capital • Cultural capital –and accepting that skill building comes in various ways other than just paid work was a relief for those of us who were expecting to be thrown into the job market cleaning bathrooms. “Training, volunteering and work trials are key stepping stones to employment. Adult apprenticeships, self-employment and social enterprise are other important routes into work that we will encourage.” Glad to hear this.

On Alcohol and Polydrug use. “Polysubstance abuse is increasingly the norm amongst drug misusers. This dependence commonly involves alcohol as well as drugs, and is therefore one of the key reasons why it makes sense to bring together the response to severe alcohol dependence and drug misuse into one strategy.

On the ground: This is an area I hope the strategy will really give the support it says it will. The alcohol treatment sector has had crumbs in terms of core funding over the last decade when there are so many people who have experienced a range of difficulties. (an est. 1.6 million people have mild, moderate or severe alcohol dependence). The strategy talks big about support and treatment, but I see little detail and there was nothing about raising the cost of our cheapest, vilest alcoholic drinks and removing them as supermarket fodder.

In conclusion

The 2010 strategy does talk a good talk in many ways, and there is a lot of comforting stuff in there for those of us who was expecting to have the rug pulled out big time. However, a glance around to see nothing but budget cuts and it just doesnt seem possible how some of the varied and personal offers of support for people are going to be enacted with the sensitivity and innovation required to make them effective, especially regarding young people, older users and those who have been out of work for many years. Ultimately, it is going to be up to the workers on the ground to give this strategy its colour; and they must also make room for the ideas and thoughts of people like us – peer workers – who have made and will continue to make unique insights into how we are to take both old and new ideas forward.

Despite being left out of the strategy, (a glaring and disturbing omission) peer workers have a clear purpose in the road ahead and should will remain an essential component as we struggle to find a way to bring in ‘recovery’, sensitively, individually, meaningfully to our services and projects. As my colleague Leigh Neal from GLADA Women’s Voices says” …It is IMPERATIVE that we are included more in future legislation and policy development as our experiences make us experts!” Especially, on this determined ‘road to recovery’.,

We may be left with a little relief in that things could have been a lot worse, yet the usual depression descends as for women – yet again – so much is left out, and so much is left wanting.

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